Perspectives in Pediatric Pathology, Chapter 25. Testicular and Paratesticular Tumors in the Pediatric Age Group

Abstract

Testicular tumors in the prepubertal age are relatively rare, representing only 9.4% of the total testicular and paratesticular specimens from a 20-year review performed at a large pediatric hospital [ 1 ]. They account for 1% to 2% of all solid tumors in the pediatric age group, with an annual incidence between 0.5/100 000 and 2/100 000 boys according to Coppes et al [ 2 ] and data from the Prepubertal Testicular Tumor Registry [ 3 ]. Similar to other neoplasms afflicting children, a bimodal age distribution is observed. The first peak is between birth and 3 years of age, and a second one occurs at the onset of puberty, extending to the fourth decade. Reports on their frequency vary because some investigators include the adolescent period, while others do not [ 4 ]. The vast majority of testicular tumors are germ cell neoplasms, accounting for 95% across all ages [ 5 ]. In children, germ cell tumors also predominate, representing 71% of all testicular neoplasms. These include yolk sac tumors (49%), teratomas (13%), seminomas and mixed germ cell tumors (9%), and sex-cord stromal tumors (29%). Malignant potential is significantly lower (less than 70%) in the pediatric age group compared to adults (90%) [ 6 ]. According to Pohl et al, 74% of prepubertal testicular tumors are benign [ 7 ].

Testicular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience

“…On the other hand, we found tumor markers increasing in patients with relapse, in accordance with data reported the literature (24)(25)(26).…”

“…Gonadal stromal tumors (NTGCTs) include Leydig cell tumor, Sertoli cell tumor, juvenile granulosa cell tumor and gonadoblastoma (21,22). As reported in literature, testicular tumors may be different, based on age-related range in histopathology, molecular biology, malignant potential, clinical behavior and treatment (12,(22)(23)(24). Moreover, malignant potential is significantly lower in the pediatric age group compared to the other age groups (25).…”

The Prognostic Role of Neutrophil-to-Lymphocyte Ratio (NLR) in Testicular Germ Cell Tumor (GCT)

“…The incidence of testicular cancer peaks near birth, followed by a shallow rate before the second peak occurring safter puberty (Nistal et al 2016). It follows a bimodal distribution with the initial peak happening before the age of four and the second peak occurring in the late 20s and early 30s (Steliarova-Foucher et al 2017).…”

Perspectives in Pediatric Pathology, Chapter 13. Calcifications in the Testis and Paratesticular Structures

“…These macrocalcifications correspond to "burnt-out" primary tumors in which tumoral remnants or undifferentiated intratubular germ cell neoplasia are revealed by histological studies [86]. [87] (see Nistal and colleagues [88]). Other nontumoral intratesticular lesions, such as epidermoid cysts and simple cysts of the testis, may show macrocalcifications in their walls.…”